DISCLOSURE STATEMENT
|
|
- Joseph Arnold
- 5 years ago
- Views:
Transcription
1 ALCOHOL USE, SUICIDE AND SUICIDAL BEHAVIOR: EVIDENCE FROM STUDIES IN THE EMERGENCY DEPARTMENT AND OTHER SETTINGS Cheryl J. Cherpitel, Dr.P.H. Alcohol Research Group Emeryville, CA The 8th Annual Guze Symposium on Alcoholism February 21, 2008 Supported, in part, by the National Institute of Alcohol Abuse and Alcoholism (2R56 AA ) 04) DISCLOSURE STATEMENT Cheryl J. Cherpitel Alcohol Research Group The 8th Annual Guze Symposium on Alcoholism February 21, 2008 Source of research support: Consulting relationships: Stock equity: Speaker s Bureaus: NIAAA None None None 1
2 More of the Epidemiology Piece Association of acute alcohol consumption (with or without intoxication) with attempted and completed suicide what we know from epidemiological studies Methodological issues, and implications for future research Literature review of published studies of adult population, 18 years and older (Cherpitel CJ, Borges G, Wilcox H. Acute alcohol use and suicidal behavior: a review of the literature. Alcohol. Clin. Exp. Res. 28:18S-28S, 28S, 2004) 2
3 Acute use measured by Any drinking prior to the event Intoxication Drinking Prior to the Event Estimated BAC Self-reports of drinking prior to the event (suicide attempts) Window for self-reports varied from 3 hours to 12 hours 6 hours was most commonly used 3
4 Intoxication at Time of the Event Varies according to legal level operating in a jurisdiction Varies, individually, in relation to amount consumed by body mass and alcohol tolerance Several Confounding Factors Affect the association of acute alcohol use and suicidal behavior Amount usually consumed/ alcohol dependence and tolerance Other drug use - interaction effects with alcohol Co-morbid psychiatric disorders (depression) 4
5 Studies of Completed Suicide sources of data Coroner s s case-series series Psychological autopsy Coroner s s Case-series series BAC is determined on toxicology screen 5
6 Psychological Autopsy Data are collected from the victim s family members and close friends on precipitating and contributing factors to help create a psychiatric profile of the person 37 Studies of Completed Suicide Covering 12 Countries United States (12 studies) Finland (8 studies) Australia (4 studies) Sweden (3 studies) Canada (2 studies) Scotland (2 studies) Brazil England Germany Northern Ireland Norway South Africa 6
7 Alcohol positive cases completed suicide Mean 37% Range 10 67% Varied by method of suicide Range of Alcohol Positive Cases by Method of Completed Suicide Percent Asphyxiation, hanging, strangulation, suffocation (5 studies) Burn, self-mutilation, electrocution (2 studies) Drowning (4 studies) Gunshot wound (8 studies) Jumping from a height (4 studies) Self-poisoning (by solid, liquid or gas) Stabbing, cutting, piercing (3 studies) Railway, motor vehicle intentional accidents (6 studies)
8 Studies of Attempted Suicide sources of data Emergency department studies Population-based studies rare events in general population 16 Studies of Attempted Suicide Covering 12 Countries England (3 studies) Northern Ireland (2 studies) United States (2 studies) Bulgaria Canada Finland India Mexico Netherlands Scotland Spain Tanzania 8
9 Alcohol positive cases attempted suicide Mean 40% Range 10 73% Majority of these studies focused on self- poisoning cases less likely to result in death Risk at which alcohol places the individual for a completed or attempted suicide is not available from these studies Control subjects are needed to establish risk Difficult with completed suicides 9
10 Two kinds of control studies have been used to examine risk for attempted suicide in ED settings Case-control study Case-crossover study Can also address the issue as to whether high concentrations of alcohol in blood diminish the risk of suicide because of the depressive effect of alcohol on the central nervous system leading to inability to initiate suicidal behavior 10
11 Case-Control Control Study (Borges G., Rosovsky H. Suicide attempts and alcohol consumption in an emergency room sample. J. Stud. Alcohol 57: , 548, 1996) Eight emergency departments in Mexico City (2,528 injured and non-injured patients) 40 patients (1.6%) attempted suicide - cases Control subjects criteria for epidemiologic studies Individuals without the outcome under study (suicide attempt) Individuals without conditions related to the exposure under study (alcohol) Individuals, had they developed the outcome under study, would have gone to the same ED and would have been included as cases 11
12 Control Patients (372) Occupational accidents (232) Recreational accidents (excluding near drowning) (124) Animal bites (16) Figure 1. Case-Control Study Risk (Odds Ratio) for Suicide Attempt by Demographic Characteristics * 1.00 * * * * * * * * * p <.05 Male Female Weekend Weekday Primary High School > High School Employed Unemployed Housewife Student Single Married Div/Widowed (Borges G., Rosovsky H. Suicide attempts and alcohol consumption in an emergency room om sample. J. Stud. Alcohol 57: , 548, 1996) 12
13 Figure 2. Case-Control Study Risk for Suicide Attempt by Substance Use Characteristics > 100 Alcohol 6 hours Prior to event (grams) * p < * 5.74 A Little Some, Very Feeling Drunk 38.29* 8.21* >.10 Est. BAC (mg %) < monthly > monthly Freq. of drinking last year > 100 Usual Consumption (grams/day) * Drug use in event (Borges G., Rosovsky H. Suicide attempts and alcohol consumption in an emergency room sample. J. Stud. Alcohol 57: , 548, 1996) Figure 3. Case-Control Study Risk of Suicide Attempt by Drinking Characteristics Controlling for Demographic Characteristics (Model A) and also Controlling for Drug Use Prior to the Event (Model B) * * * 7.3* 8.3* * gram > 100 gram gram > 100 gram > > gram > 100 gram gram > 100 gram Model A Model B Model A Model B Model A Model B Drinking Prior to Event Estimated BAC (mg%) Usual Alcohol Consumption * p <.05 (grams/day) (Borges G., Rosovsky H. Suicide attempts and alcohol consumption in an emergency room sample. J. Stud. Alcohol 57: , 548, 1996) 13
14 Self-reported alcohol consumption prior to the suicide attempt suggests a dose-response relationship. Estimated BAC at the time of ED admission suggests at higher levels, attempted suicide may be less likely. BAC at time of ED admission has not been well correlated with self-reports of consumption Usual alcohol consumption not significantly associated with suicidal attempts. Did not test for interaction or usual use with acute use Drug use is likely a major mode of attempted suicide (47% of those attempting suicide reported drug use within six hours prior to attempt) When controlling for drug use prior to the attempt, risk related to alcohol use increased from an odds ratio of 60 to an odds ratio of 90 Potential interaction of alcohol use and drug use not tested 14
15 Case-Crossover Crossover Study Case-Control Control studies cannot control for other unknown variables which may be important in the alcohol-suicide relationship Case-Crossover Crossover design was developed to address this concern (Maclure M. Amer. J. Epidemiol. 1991) Measures the impact of a transient effect (alcohol consumption) on an acute event (suicide attempt) (originally applied to the study of heavy physical exertion on triggering an acute myocardial infarction) (Mittleman M, Maclue M, Tofler G. New Eng. J. Med. 1993) Each individual is used as his or her own control 2 Methods Predetermined control period approach Usual frequency approach 15
16 Between-person characteristics that may be associated with a suicide attempt, such as demographic characteristics and usual drinking patterns are controlled. Allows for an analysis of acute alcohol consumption on suicide attempt without the potential effect of other confounding variables. Case-Crossover Crossover Study (Borges G, Cherpitel CJ, Macdonald S, Giesbrecht N, Stockwell T, Wilcox H. A case-crossover crossover study of acute alcohol use and suicide attempt. J. Stud. Alcohol 65: , 714, 2004) 18 EDs which used probability sampling of patients Mexico City (8) Acapulco, Mexico (3) Pachuca, Mexico (3) Australia (Western Australia) Canada (Alberta) Canada (Quebec) United States (Santa Clara, CA) Studies are part of the Emergency Room Collaborative Alcohol Analysis Project, all using the same methods and instruments 16
17 Cases of attempted suicide (102) Mexico 43 Australia 47 Canada 9 United States 3 48% female 59% under 30 23% were BAC positive 35% reported drinking within six hours prior to the suicide attempt Relative Risk of attempted suicide from drinking derived from each patient s drinking within six hours prior to injury compared to the expected likelihood of drinking during that time based on reported usual frequency and quantity of drinking during the last year. Overall relative risk 9.6 Range 29.9 in Mexico (episodic/fiesta drinking) 6.1 in Australia (more frequent drinking) 17
18 Figure 4. Case-Crossover Analysis of Relative risk (RR) of Suicide Attempt from Drinking Within Six Hours Prior to the Event Effect of Risk Modifiers Alcohol 6 hrs Prior Male Female < 30 > 30 Married Single Sep/Divorced < 8th Grade High School College Infrequent Light Moderate Heavy Quantity/Frequency of drinking No Yes 5+ Drinks (Borges G, Cherpitel CJ, Macdonald S, Giesbrecht N, Stockwell T, Wilcox H. A casecrossover study of acute alcohol use and suicide attempt. J. Stud. Alcohol , 2004) Some suggestion that a higher risk is associated with drinking within one hour prior to the event, and risk decreases as the length of time between the last drink and the suicide attempt increases. 18
19 Numbers were small for these analyses. Only 18 of 36 patients provided exact time between drinking and suicide attempt Half of these reported drinking within one hour prior to the suicide attempt Recall for drinking in closer proximity to the suicide attempt is probably better than for drinking further removed from the event. To highlight methodological limitations of studies attempted and completed suicide Small sample sizes a relatively rare event In the review of published studies on prevalence of alcohol, 7 of o the completed suicide studies and 3 of the attempted suicide studies had sample sizes less than 50 These prevalence estimates of alcohol involvement will be less precise and account for the broad range found for the prevalence of alcohol in both attempted and completed suicide cases Few studies reported suicide across all methods it would be expected that alcohol s s prevalence comparatively may vary by method 19
20 Misclassification bias For an intoxicated individual in the absence of some indication of intention it may be difficult to determine whether a fatal injury was intentional, or whether it was accidental and due to an inebriated state. Poisoning and drowning are the two cause-of-death categories most implicated in suicide misclassification. The black-white suicide paradox Between 1999 & 2002 suicide rates for whites were double those for blacks (11.8/100,000 vs. 5.5/100,000) Raises the question of a disparity in data quality with blacks being more likely to be misclassified Ascertainment of BAC is problematic Criteria for postmortem toxicology screening varies in relation to time since death occurred Level of BAC regarded as a contributory cause Ascertainment often incomplete Trauma centers/eds Coroner 20
21 Limitations of Study Designs Based on cross-sectional or retrospective studies Data are limited to prevalence estimates No control populations Risk of suicide associated with drinking prior to the event cannot be estimated Risk can be estimated from Case-control study design Case-crossover study design 21
22 Future Epidemiological Research Case-crossover study pre-determined control period method Develop surveillance systems in emergency departments NIAAA, 1999 Need to develop more innovative research designs to examine the causal role of alcohol in suicide, homicide and other violent events. National Institute on Alcohol Abuse and Alcoholism. Report of a Sub-committee of the National Advisory Council on Alcohol Abuse and Alcoholism on the Review of the Extramural Research Portfolio for Epidemiology,
Blood alcohol levels in suicide cases
Journal of Epidemiology and Community Health 1992; 46: 256-260 Health Department of Western Australia, PO Box 8172, Stirling Street, Perth, Western Australia 6000: Epidemiology Branch L Hayward Neurosciences
More informationThe Role of Race/Ethnicity in Alcohol-attributable Injury in the United States
Epidemiologic Reviews ª The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
More informationThe accident injuries situation
Appendix 2. The accident injuries situation Almost 90 % of injury deaths take place in home and leisure Almost 80 % of accidents leading to injury take place in home and leisure Unintentional injuries
More information508 the number of suicide deaths in deaths per 100,000 people was the suicide rate in Suicide deaths in 2013 by gender
An overview of suicide statistics This document summarises information about suicide deaths in New Zealand covering up to 13. It does not attempt to explain causes of suicidal behaviour or causes of changes
More informationTABLE OF CONTENTS INTRODUCTION 1 -SUMMARY OF CONTENTS 2 -DEATHS REPORTABLE TO THE CORONER 3 INVESTIGATIONS, CORONER CASES AND AUTOPSIES 6
TABLE OF CONTENTS INTRODUCTION 1 -SUMMARY OF CONTENTS 2 -DEATHS REPORTABLE TO THE CORONER 3 INVESTIGATIONS, CORONER CASES AND AUTOPSIES 6 -SUMMARY OF REPORTABLE DEATHS 7 -SUMMARY OF INVESTIGATIONS 5-YEARS
More informationThe burden caused by alcohol
The burden caused by alcohol Presentation at REDUCING THE HARM CAUSED BY ALCOHOL: A COORDINATED EUROPEAN RESPONSE Tuesday, November 13 Jürgen Rehm Centre for Addiction and Mental Health, Toronto, Canada
More informationNatural Deaths 61 Investigated/PND 14 Accidental Deaths 123 Suicides 37 Homicides 8 Stillborn 2 SUIDS 1 Cannot Be Determined 4 Pending 0
2016 Report for the Coroner's Office S. Timothy Warco Washington County, Pennsylvania Population Served, 2015 Estimate: 208,261 Area Served, Mi 2 861 Total cases reported to the Coroner's Office 2137 View
More informationSteve Moore Sheriff-Coroner Public Administrator
OFFICE OF ========SHERIFF-CORONER = COUNTY OF SAN JOAQUIN 7000 Michael N. Canlis Blvd. French Camp, California 95231-9781 Steve Moore Sheriff-Coroner Public Administrator April 1, 2014 Honorable Members
More informationANNUAL REPORT OF THE CORONER
ANNUAL REPORT OF THE CORONER 2007 STEVE MOORE SHERIFF-CORONER PUBLIC ADMINISTRATOR 7000 MICHAEL N.CANLIS BLVD. FRENCH CAMP, CA. 95231 (209) 468-4300 www.sjsheriff.org TABLE OF CONTENTS INTRODUCTION 1
More informationNational Institute on Alcohol Abuse and Alcoholism. Environmental Approaches
Environmental Approaches Consumption of 10+ and 21+ Drinks on an Occasion At Least Once in the Past Year, 2013 30 25 20 15 10+ drinks 15 25 10+ drinks 16 25 10 5 0 21+ drinks 3 2 21+ drinks 18-20 21-24
More informationA ccidental and intentional injuries are leading causes of
688 RESEARCH REPORT Social aetiology of violent in Swedish children and youth A Hjern, S Bremberg... See end of article for authors affiliations... Correspondence to: Dr S Bremberg, Department of Public
More informationANNUAL REPORT OF THE CORONER 2012
ANNUAL REPORT OF THE CORONER 2012 STEVE MOORE SHERIFF-CORONER PUBLIC ADMINISTRATOR 7000 MICHAEL N.CANLIS BLVD. FRENCH CAMP, CA. 95231 (209) 468-4300 www.sjsheriff.org OFFICE OF ========SHERIFF-CORONER=
More information25 September 2012 Early Years Pathfinder. misuse. Insert name of presentation on Master Slide. Presenter: Dr Sarah J Jones
25 September 2012 Early Years Pathfinder Project Substance misuse Insert name of presentation on Master Slide Presenter: Dr Sarah J Jones Presentation aim To present the findings of the review Background
More informationDELIBERATE SELF-HARM AND RELATIONSHIP TO ALCOHOL USE AT AN EMERGENCY DEPARTMENT
DELIBERATE SELF-HARM AND RELATIOHIP TO ALCOHOL USE AT AN EMERGENCY DEPARTMENT IN EASTERN TAIWAN Yin-Ming Li Department of Family Medicine, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien,
More informationTRENDS OF UNNATURAL DEATHS IN LATUR DISTRICT OF MAHARASHTRA Dr. MEBansude, Dr. RV Kachare, Dr. CR Dode, VMKumre
(Jul- Dec 22) Original Article TRENDS OF UNNATURAL DEATHS IN LATUR DISTRICT OF MAHARASHTRA Dr. MEBansude, Dr. RV Kachare, Dr. CR Dode, VMKumre Authors Dr. M.E. Bansude, MD (Forensic Medicine) Assistant
More informationRisk factors associated with alcohol related self-harm and suicide: New insights and improving evidence based policy and practice
Risk factors associated with alcohol related self-harm and suicide: New insights and improving evidence based policy and practice 26 th October 2017 Professor Ella Arensman National Suicide Research Foundation,
More informationThe etiology of the trauma was defined as the mechanism by which the traumatic event occurred and
APPENDIX 2: Additional Methodological Details The etiology of the trauma was defined as the mechanism by which the traumatic event occurred and consisted of the following fifteen categories: motor vehicle
More informationYAKIMA COUNTY CORONER ANNUAL SUMMARY 2018
FOEWORD The Yakima Coroner s Office serves the community by investigating sudden, unexpected, violent, suspicious, or unnatural deaths. The Coroner s staff recognizes the tragedy surrounding any untimely
More informationAlcohol and Violent Death: The Role of Alcohol in Homicides and Suicides in North Carolina
Alcohol and Violent Death: The Role of Alcohol in Homicides and Suicides in North Carolina Presented by Kathleen Creppage, MPH CSTE Annual Conference June 11, 2013 Kathleen Creppage, CDC/CSTE Applied Epidemiology
More informationResident Death By Suicide Statistics
Resident Death By Suicide Statistics Just the Facts: Resident death by suicide is less frequent than the general population. Overall suicide is the #2 cause of resident death. It is the #1 cause of death
More informationWashoe County Regional Medical Examiner s Office Data on Suicides in Northern Nevada
Washoe County Regional Medical Examiner s Office 2016 Data on Suicides in Northern Nevada Table of Contents Letter from the Chief Medical Examiner... 1 Letter from the Office of Suicide Prevention... 3
More informationDEATHS OF PERSONS AGED 13 to 25 YEARS IN AUSTRALIA (EXCLUDING QLD & SA) WHICH INVOLVED ALCOHOL (Reported to a coroner between 2003 and 2006)
NATIONAL CORONERS INFORMATION SYSTEM (NCIS) ISSUES OF INTEREST SERIES (Edition 1) DEATHS OF PERSONS AGED 13 to 25 YEARS IN AUSTRALIA (EXCLUDING QLD & SA) WHICH INVOLVED ALCOHOL (Reported to a coroner between
More informationViolent Death among First Responders: Using North Carolina Violent Death Reporting System Data to Inform Prevention
Violent Death among First Responders: Using North Carolina Violent Death Reporting System Data to Inform Prevention Safe States Annual Meeting 2015 April 30 th, 2015 Source: 1 Parsons, J. Occupational
More informationSuicide and suicidal behaviour in alcohol use disorders
Suicide and suicidal behaviour in alcohol use disorders Dr Julia Sinclair Senior Lecturer in Psychiatry University of Southampton Overview Suicide and suicidal behaviour Definitions Context: UK rates Risk
More informationWHATCOM COUNTY MEDICAL EXAMINER 1500 NORTH STATE STREET BELLINGHAM, WA ANNUAL REPORT
WHATCOM COUNTY MEDICAL EXAMINER NORTH STATE STREET BELLINGHAM, WA 9 ANNUAL REPORT During the Whatcom County Medical Examiner s office assumed jurisdiction in death investigations that involved forensic
More informationSuicide, Impulsivity, and Comorbidity. Disclosure Statement Alan C. Swann MD
Suicide, Impulsivity, and Comorbidity Alan C. Swann MD University of Texas Health Science Center, Houston Disclosure Statement Alan C. Swann MD University of Texas Health Science Center, Houston The 8th
More informationBERRIEN COUNTY MEDICAL EXAMINER 2015 ANNUAL REPORT. Office of the Medical Examiner 2149 E. Napier Avenue Benton Harbor, MI
BERRIEN COUNTY MEDICAL EXAMINER 2015 ANNUAL REPORT Office of the Medical Examiner 2149 E. Napier Avenue Benton Harbor, MI. 49022 Number Two! Our second Annual Medical Examiner Report. Too soon for trend
More informationDEPARTMENT OF CORONER
DEPARTMENT OF CORONER AGENCY REPORT INTRODUCTION The Department of Coroner is mandated by law to inquire into and determine the circumstances, manner, and cause of all violent, sudden, or unusual deaths;
More informationGraph 20. Causes of Natural Death Examined by the Medical Examiner in Graph 21: Race of Decedents Who Died of Natural Disease...
Table of Contents Introduction... 4 County Demographics... 5 Workload... 5 Graph 1: Total ME cases vs. PBC population... 5 Manner of Death... 5 Figure 1: Florida death certificate with manner and cause
More informationTemporal variation in deaths related to alcohol intoxication and drinking
Published by Oxford University Press on behalf of the International Epidemiological Association International Journal of Epidemiology 2005;34:765 771 The Author 2005; all rights reserved. Advance Access
More informationMACOMB COUNTY MEDICAL EXAMINER
MACOMB COUNTY MEDICAL EXAMINER Annual Report Daniel J. Spitz, M.D. Chief Medical Examiner Table of Contents LETTER FROM THE MANNER OF DEATH - NATURAL. MEDICAL EXAMINER Natural Cases by Age/Gender... Natural
More informationWashtenaw County Medical Examiner
Washtenaw County Medical Examiner 2009 Annual Report Office of the Medical Examiner 300 N. Ingalls NI2D22, SPC 5452 Ann Arbor, Michigan 48109 Phone 734-232-1127 Fax 734-615-8811 1 Table of Contents: Washtenaw
More informationToward a Policy-Relevant Typology of Cannabis Use for Canada
March 2006 Toward a Policy-Relevant Typology of Cannabis Use for Canada Analysis drawn from the 2004 Canadian Addiction Survey For additional copies, contact the Canadian Centre on Substance Abuse, 75
More informationThe Unexpected Public Health Effects of the 21 Drinking Age
The Unexpected Public Health Effects of the 21 Drinking Age Richard A (Rick) Grucza, PhD MPE 12 th Annual Guze Symposium on Alcoholism Missouri Alcoholism Research Center Washington University, St. Louis,
More informationBACKGROUND AND RATIONALE
ULTRA RARE DISEASE EXAMPLE: SURVIVAL IN PATIENTS WITH NIEMANN PICK-C DISEASE Daniel Rosenberg, PhD Head of Epidemiology BACKGROUND AND RATIONALE Niemann Pick Type-C (NP-C) disease is an ultra rare condition
More informationChildhood Injury Deaths in Baltimore City
Childhood Injury Deaths in Baltimore City 2002-2006 A Report from the Office of Epidemiology and Planning Baltimore City Health Department Prepared for the Baltimore City Child Fatality Review Team February
More informationRole of alcohol in the Eastern European mortality crisis
Role of alcohol in the Eastern European mortality crisis Martin Bobak Department of Epidemiology and Public Health Multiple influences on health Social structure Corruption Exclusion Mass privatisation
More informationCHC08 Community Services Training Package. CHCCS521B Assess and respond to individuals at risk of suicide SAMPLE. Learner guide.
CHC08 Community Services Training Package CHCCS521B Assess and respond to individuals at risk of suicide Learner guide Version 1 INDUSTRY SKILLS UNIT MEADOWBANK Product Code: 5679 CHCCS521ABAssess and
More informationSelecting and Implementing Effective Community Prevention Strategies. How to Use Science in Practice"
Selecting and Implementing Effective Community Prevention Strategies How to Use Science in Practice" Harold D. Holder, Ph.D. Prevention Research Center Berkeley, California USA Biggest current mistakes
More informationAlcohol Under 21 years old. Rory M Doyle, M.Sc Office of the Chief Medical Examiner Washington, DC
Alcohol Under 21 years old Rory M Doyle, M.Sc Office of the Chief Medical Examiner Washington, DC Rory.Doyle@dc.gov EU Drinking Age Limits Country Drinking age Purchase Age Country Drinking Age Purchase
More informationDrug-related deaths and deaths among drug users in Ireland figures from the National Drug-Related Deaths Index
Drug-related deaths and deaths among drug users in Ireland 21 figures from the National Drug-Related Deaths Index January 213 Summary of 21 results This update presents figures from the National Drug-Related
More informationForensic Pathology & Death Investigation in Arizona
Forensic Pathology & Death Investigation in Arizona Arizona Society of Pathologists 2014 Fall Conference Gregory L. Hess, MD Chief Medical Examiner Pima County Office of the Medical Examiner 1 Overview
More informationOverview. Purpose of the Medical Examiner s Office. Purpose of the Medical Examiner s Office. Purpose of the Medical Examiner s Office
Forensic Pathology & Death Investigation in Arizona Arizona Society of Pathologists 2014 Fall Conference Gregory L. Hess, MD Chief Medical Examiner Pima County Office of the Medical Examiner Overview Purpose
More informationCocaine and Methamphetamine related drug-induced deaths in Australia, 2011
Cocaine and Methamphetamine related drug-induced deaths in Australia, 2011 Recommended citation: Roxburgh, A. and Burns, L (2015). Cocaine and methamphetamine related drug-induced deaths in Australia,
More informationKent County Medical Examiner
Kent County Medical Examiner 26 Annual Report Office of the Medical Examiner 7 Fuller N.E. Grand Rapids, Michigan 4953 26 Kent County Medical Examiner Annual Report To the Kent County Board of Commissioners,
More informationDEPARTMENT OF CORONER
DEPARTMENT OF CORONER AGENCY REPORT INTRODUCTION The Department of Coroner is mandated by law to inquire into and determine the circumstances, manner, and cause of all violent, sudden, or unusual deaths;
More informationKenneth W. Mahaffey, MD and Keith AA Fox, MB ChB
Once-daily oral direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation Kenneth W. Mahaffey, MD and Keith AA Fox, MB ChB on behalf
More informationGenetic and environmental influences on alcohol drinking behavior
Washington University School of Medicine Digital Commons@Becker Presentations 2004: Alcoholism and the Latest Genetics and Neuroscience Findings 2004 Genetic and environmental influences on alcohol drinking
More informationPERSPECTIVES ON DRUGS Emergency health consequences of cocaine use in Europe
UPDATED 16. 5. 2014 PERSPECTIVES ON DRUGS Emergency health consequences of cocaine use in Europe Every year, several thousands of cocainerelated emergencies are reported in Europe, along with hundreds
More informationSAN FRANCISCO WHOLE PERSON CARE Homeless Mortality in San Francisco Opportunities for Prevention
SAN FRANCISCO WHOLE PERSON CARE Homeless Mortality in San Francisco Opportunities for Prevention Barry Zevin MD and Caroline Cawley MPH Health Commission Feb 19 2019 Background materials What this work
More informationNVDRS Mission. To collect high quality, detailed, timely information on all violent deaths in the US
NVDRS Mission To collect high quality, detailed, timely information on all violent deaths in the US What is the NVDRS? A public health surveillance system Population-based Active Census designed to obtain
More informationSelf-inflicted injuries. Trusha Brys VFPMS seminar 2019
Self-inflicted injuries Trusha Brys VFPMS seminar 2019 FORENSIC SETTING Circumstances surrounding injury must be addressed investigators, courts, complainant, accused Death -Is it murder, suicide or an
More informationSPECIAL SESSION: SUICIDE IN ROAD TRAFFIC
SPECIAL SESSION: SUICIDE IN ROAD TRAFFIC Session Organizer: Swedish Transport Administration Kenneth Svensson, Special Adviser Traffic Safety 405 33, Gothenburg, Sweden Phone: + 46 10 123 59 89 E-mail:
More informationInitial Report of Oregon s State Epidemiological Outcomes Workgroup. Prepared by:
Alcohol Consumption and Consequences in Oregon Prepared by: Addictions & Mental Health Division 5 Summer Street NE Salem, OR 9731-1118 To the reader, This report is one of three epidemiological profiles
More informationJürgen Rehm 1,2,3, Robert Mann 1,2 & Jayadeep Patra 1 1 Centre for Addiction and Mental Health, Toronto, Canada 2 Dalla Lana School of Public Health,
Jürgen Rehm,2,3, Robert Mann,2 & Jayadeep Patra Centre for Addiction and Mental Health, Toronto, Canada 2 Dalla Lana School of Public Health, University of Toronto, Canada 3 TU Dresden, Germany Based on
More informationUsing Environmental Strategies for Prevention. Brenda A. Miller Prevention Research Center PIRE Berkeley, CA, USA
Using Environmental Strategies for Prevention Brenda A. Miller Prevention Research Center PIRE Berkeley, CA, USA Addressing Community System of Alcohol/Drug Use Social Control and Communication Use Legal
More informationNCIS Coding Tips. Coding Alcohol and Drug Related Deaths
NCIS Coding Tips Coding Alcohol and Drug Related Deaths In terms of NCIS coding, alcohol and drugs may be involved in a death in the following ways: The primary cause of a death, i.e. drug overdose OR
More informationNatural Deaths 39 Investigated/PND 15 Accidental Deaths 131 Suicides 38 Homicides 4 Stillborn 1 SUIDS 3 Cannot Be Determined 5 Pending 0
2017 Report for the Coroner's Office S. Timothy Warco Washington County, Pennsylvania Population Served, 2015 Estimate: 208,261 Area Served, Mi 2 861 Total cases reported to the Coroner's Office 2068 View
More informationThe Correlation of Patients with Spinal Cord Injury and Psychiatric Disorders. Ching Hui, Chuang Chung Hey, Chen
The Correlation of Patients with Spinal Cord Injury and Psychiatric Disorders Ching Hui, Chuang Chung Hey, Chen Introduction Spinal cord injury (SCI) is a common devastating accident in modern society.
More informationUsing NVDRS in Oregon
Using NVDRS in Oregon Lisa Millet, MSH Injury Prevention & Epidemiology Section Manager Office of Disease Prevention & Epidemiology Oregon Public Health Division SAMHSA Grantee Conference Portland, December
More informationIN 1998, THE NATIONAL ADVISORY COUNCIL of
12 JOURNAL OF STUDIES ON ALCOHOL AND DRUGS / SUPPLEMENT NO. 16, 2009 Magnitude of and Trends in Alcohol-Related Mortality and Morbidity Among U.S. College Students Ages 18-24, 1998-2005 RALPH W. HINGSON,
More informationThe Severity of Pedestrian Injuries in Alcohol-Related Collisions
The Severity of Pedestrian Injuries in -Related Collisions AUTHORS: Stanley Sciortino, PhD Elyse Chiapello San Francisco Department of Public Health Community Health Education Section The California Statewide
More informationDemographics and Health Data
Demographics and Health Data Information for Local Planners City of Puyallup, WA Demographic Characteristics Environmental Health Division 3629 South D Street, Tacoma, WA 98418 (253) 798-6470 Table 1 presents
More informationKent County Medical Examiner
Kent County Medical Examiner 22 Annual Report Office of the Medical Examiner 7 Fuller N.E. Grand Rapids, Michigan 4953 22 Kent County Medical Examiner Annual Report To the Kent County Board of Commissioners,
More informationWHATCOM COUNTY MEDICAL EXAMINER 1500 NORTH STATE STREET BELLINGHAM, WA ANNUAL REPORT
WHATCOM COUNTY MEDICAL EXAMINER 1500 NORTH STATE STREET BELLINGHAM, WA 98225 2011 ANNUAL REPORT During 2011 the Whatcom County Medical Examiner s office assumed jurisdiction in 89 death investigations
More informationDemographics and Health Data
Demographics and Health Data Information for Local Planners City of Lakewood, WA Demographic Characteristics Environmental Health Division 3629 South D Street, Tacoma, WA 98418 (253) 798-6470 Table 1 presents
More informationAlcohol-related injury: An evidence-based literature review
Alcohol-related injury: An evidence-based literature review February 2012 Confidential Alcohol-related injury: An evidence-based literature review PREPARED FOR PREPARED BY CONTACT DETAILS PROJECT NUMBER
More informationCRISIS COUNSELLING IN PLHIV WITH SUICIDAL IDEATION
CRISIS COUNSELLING IN PLHIV WITH SUICIDAL IDEATION PRESENTED AT AWACC 2016 DURBAN, SOUTH AFRICA PROFESSOR LOURENS SCHLEBUSCH EMERITUS PROFESSOR BEHAVIOURAL MEDICINE UNIVERSITY OF KWAZULU-NATAL DURBAN SOUTH
More informationALCOHOL RELATED DEATHS REGISTERED IN NORTHERN IRELAND ( )
ALCOHOL RELATED DEATHS REGISTERED IN NORTHERN IRELAND (1999-2009) 9.30am Thursday, 16 December 2010 Introduction 1. This report looks at the most recent official death registration data available on alcohol
More informationINVOLVEMENT OF DRUGS IN ACCIDENT CAUSATION
INVOLVEMENT OF DRUGS IN ACCIDENT CAUSATION Jim GEROSTAMOULOS, Helen BATZIRIS, Olaf H. DRUMMER Victorian Institute of Forensic Medicine and Department of Forensic Medicine, Monash University, Southbank,
More informationAlcohol - A Review P&A PAPE & ASSOCIATES TOXICOLOGY REPORTER. Specializing in Toxicology. Premortem Alcohol Testing. Postmortem Alcohol Testing
s Alcohol - A Review P&A PAPE & ASSOCIATES Specializing in Toxicology TOXICOLOGY REPORTER Premortem Alcohol Testing Postmortem Alcohol Testing Case Analysis Statements and Testimony Case-relevant records
More information2013 Youth Suicide Report
New Jersey Department of Children and Families 2013 Youth Suicide Report Data Overview and Recommendations on Youth Suicide in New Jersey Allison Blake, Ph.D., L.S.W. Commissioner Table of Content Executive
More informationSuicide in the Region of Peel and Ontario
Suicide in the Region of Peel and Ontario HIGHLIGHTS In 21/22 in the Region of Peel, 6.2% of residents reported that they had suicidal thoughts in their lifetime. Almost 2% reported having suicidal thoughts
More informationINCIDENCE, HEALTH OUTCOMES AND COSTS RELATED TO MOTOR VEHICLE CRASHES IN WHICH ALCOHOL WAS A FACTOR, WISCONSIN, 2006
Crash Outcome Data Evaluation System INCIDENCE, HEALTH OUTCOMES AND COSTS RELATED TO MOTOR VEHICLE CRASHES IN WHICH ALCOHOL WAS A FACTOR, WISCONSIN, 2006 Wayne Bigelow Center for Health Systems Research
More informationREVISED. Tulare County 2007
Indicators of Alcohol and Other Drug Risk and Consequences for California Counties REVISED Tulare County 2007 Indicators of Alcohol and Other Drug Risk and Consequences for California Counties Tulare County
More informationHealthy Connecticut 2020: A Call to Action
C O N N E C T I C U T HEALTH IMPROVEMENT PLANNING COALITION Healthy Connecticut 2020: A Call to Action Kristin L. Sullivan, MA Public Health Systems Improvement Connecticut Department of Public Health
More informationTHE PRESENCE OF ALCOHOL AND/OR DRUGS IN MOTOR VEHICLE FATALITIES, BY JURISDICTION: CANADA, 2013 November 15, 2017
THE PRESENCE OF ALCOHOL AND/OR DRUGS IN MOTOR VEHICLE FATALITIES, BY JURISDICTION: CANADA, 2013 November 15, 2017 R. Solomon, Distinguished University Professor, C. Ellis, J.D. 2018 & C. Zheng, J.D. 2019
More informationEDRS. trends. bulletin. Alcohol use disorders amongst a group of regular ecstasy users. Key findings. july Introduction.
ecstasy and related drug trends july 2011 bulletin Authors: Sheena Arora and Lucy Burns, National Drug and Alcohol Research Centre, University of New South Wales Suggested citation: Arora, S. & Burns,
More informationYouth Depression & Suicide
Youth Depression & Suicide Hatim Omar, M.D. Professor, Pediatrics & Ob\Gyn. Chief, Division of Adolescent Medicine & Young Parent Program Department of Pediatrics University of Kentucky Email: haomar2@uky.edu
More informationColorado Trends in Suicide: Annual Report from the Office of Suicide Prevention Suicide Prevention Coalition of Colorado August 12, 2015
Colorado Trends in Suicide: Annual Report from the Office of Suicide Prevention Suicide Prevention Coalition of Colorado August 12, 2015 Sources of information/data National National Violent Death Reporting
More informationDP Health Economics and Decision Science (HEDS) Discussion Paper. Research.
Health Economics and Decision Science (HEDS) School Of Health And Related Research. Discussion Paper Injury Alcohol-Attributable Fractions: Methodological Issues and Developments Daniel Hill-McManus, Colin
More informationAlcohol-related Hospital Statistics Scotland 2011/12
Publication Report Alcohol-related Hospital Statistics Scotland 2011/12 Publication date 24th September 2013 A National Statistics Publication for Scotland Contents Introduction... 2 Key points... 3 Results
More informationREVISED. Humboldt County 2007
Indicators of Alcohol and Other Drug Risk and Consequences for California Counties REVISED Humboldt County 2007 Indicators of Alcohol and Other Drug Risk and Consequences for California Counties Humboldt
More informationMarin County Sheriff s Office Coroner Division Five Year Report
Marin County Sheriff s Office Coroner Division Five Year Report 211-215 Robert T. Doyle, Sheriff-Coroner Table of Contents Introduction... 3 Staff... 4 Reportable Criteria...... 5 Statistics for 211 to
More informationSTEPHEN P. NONN OFFICE OF THE CORONER MADISON COUNTY, ILLINOIS 157 MAIN STREET SUITE 354 EDWARDSVILLE, IL
MAIN OFFICE: (618) 692-7478 MORGUE: (618) 296-4525 FAX: (618) 692-6042 FAX: (618) 692-9304 STEPHEN P. NONN OFFICE OF THE CORONER MADISON COUNTY, ILLINOIS 157 MAIN STREET SUITE 354 EDWARDSVILLE, IL. 62025-1962
More informationAlcohol Awareness: Rodeo Rundown! HOW IT AFFECTS THE BRAIN, THE BODY, AND HOW MUCH IS TOO MUCH?
Alcohol Awareness: Rodeo Rundown! HOW IT AFFECTS THE BRAIN, THE BODY, AND HOW MUCH IS TOO MUCH? What about Alcohol? Cerebral Cortex Hippocampus Limbic System Cerebellum Hypothalamus Medulla Alcohol Poisoning
More informationUNUSUAL SEXUAL DEVIATIONS IN A YOUNG MAN: A CASE REPORT A. John Dinesh 1, S. Arun 2, S. Alok Pandey 3, P. Devaraja 4
UNUSUAL SEXUAL DEVIATIONS IN A YOUNG MAN: A A. John Dinesh 1, S. Arun 2, S. Alok Pandey 3, P. Devaraja 4 HOW TO CITE THIS ARTICLE: A. John Dinesh, S. Arun, S. Alok Pandey, P. Devaraja. Unusual Sexual Deviations
More informationSuicide in Wales. Professor Keith Lloyd School of Medicine.
Suicide in Wales Professor Keith Lloyd School of Medicine www.swansea.ac.uk Definitions Suicide intentionally killing oneself Self harm intentional selfpoisoning or selfinjury, irrespective of the nature
More informationMANNER OF DEATH OF OLDER PEOPLE WITH REGARD TO BLOOD ALCOHOL CONCENTRATION
Cent Eur J Public Health 2017; 25 (4): 266 270 MANNER OF DEATH OF OLDER PEOPLE WITH REGARD TO BLOOD ALCOHOL CONCENTRATION Lubica Juríčková 1, Kateřina Ivanová 1, Martin Dobiáš 2, Richard Andrášik 3, Peter
More informationSUICIDE IN SAN DIEGO COUNTY:
SUICIDE IN SAN DIEGO COUNTY: 1998-2007 www.sdchip.org Contents www.sdchip.org SUICIDE IN SAN DIEGO COUNTY: 1998-2007 CHIP's Message Dear Reader, Community Health Improvement Partners (CHIP) is pleased
More informationVEHICULAR FATALITIES IN CUYAHOGA COUNTY, OHIO, U.S.A. Twenty Years Experience ( )
VEHICULAR FATALITIES IN CUYAHOGA COUNTY, OHIO, U.S.A. Twenty Years Experience (1941-1960) by S. R. GERBER* Orientation THE c o u n t y of Cuyahoga in the State of Ohio encompasses an area of slightly more
More informationAccidental drug-induced deaths due to opioids in Australia, 2013
Prepared by Funded by Product of Amanda Roxburgh and Lucy Burns, National Drug and Alcohol Research Centre the Australian Government Department of Health the National Illicit Drug Indicators Project Recommended
More informationChapter 10 Section 1 Notes
Chapter 10 Section 1 Notes Alcohol Is a Drug Alcohol is the drug found in beer, wine, and liquor that causes intoxication. Intoxication includes all the physical and mental changes produced by drinking
More informationRETROSPECTIVE ANALYSIS OF DEATH DUE TO BURNS IN RURAL REGION Dr. U Gonnade, Dr. JM Farooqui
Original Article RETROSPECTIVE ANALYSIS OF DEATH DUE TO BURNS IN RURAL REGION Dr. U Gonnade, Dr. JM Farooqui Authors Dr. U Gonnade, Third Year Postgraduate student, Department of Forensic Medicine & Toxicology,
More informationOntario Injury Prevention Resource Centre.
A presentation of Ontario Injury Prevention Resource Centre Supporting practitioners to reduce injury in Ontario www.oninjuryresources.ca Fundamentals for Injury Prevention Practitioners Module 2 Common
More informationSUICIDE AND ACCIDENT CLASSIFICATION METHODOLOGY
SUICIDE AND ACCIDENT CLASSIFICATION METHODOLOGY Kenneth Svensson Swedish Transport Administration, Special Adviser Traffic Safety 405 33, Gothenburg, Sweden Phone: + 46 10 123 59 89 E-mail: kenneth.svensson@trafikverket.se
More informationYing-Yeh Chen M.D., Sc.D. Attending Psychiatrist, Taipei City Psychiatric Center Associate Professor, National Yang-Ming University
Ying-Yeh Chen M.D., Sc.D. Attending Psychiatrist, Taipei City Psychiatric Center Associate Professor, National Yang-Ming University 1. Pattern of suicide in Taiwan and Taipei City 2. Suicide attempters
More informationDrug-related deaths and deaths among drug users in Ireland figures from the National Drug-Related Deaths Index
Drug-related deaths and deaths among drug users in Ireland 2011 figures from the National Drug-Related Deaths Index January 2014 Summary of 2011 results This update presents figures from the National Drug-Related
More informationWHATCOM COUNTY MEDICAL EXAMINER 1500 NORTH STATE STREET BELLINGHAM, WA ANNUAL REPORT
WHATCOM COUNTY MEDICAL EXAMINER 1500 NORTH STATE STREET BELLINGHAM, WA 98225 2010 ANNUAL REPORT During 2010 the Whatcom County Medical Examiner s office assumed jurisdiction in 107 death investigations
More informationHOW SAFE ARE OUR ROADS?
HOW SAFE ARE OUR ROADS? 2017 annual data report on the impact of drunk driving on road safety in the Washington D.C. metropolitan region December 2018 HOW SAFE ARE OUR ROADS? ANNUAL DATA REPORT ON THE
More information